Radioactive Iodine Treatment Of Hyperthyroidism Research Articles

Rapid progression of heart failure secondary to radioactive iodine treatment of hyperthyroidism: A case report

In recent years, because of the growing desire to improve the noninvasiveness and safety of tumor treatments, sonodynamic therapy has gradually become a popular research topic. However, due to the complexity of the therapeutic process, the relevant mechanisms have not yet been fully elucidated. One of the widely accepted possibilities involves the effect of reactive oxygen species. In this review, the mechanism of reactive oxygen species production by sonodynamic therapy (SDT) and ways to enhance the sonodynamic production of reactive oxygen species are reviewed. Then, the clinical application and limitations of SDT are discussed. In conclusion, current research on sonodynamic therapy should focus on the development of sonosensitizers that efficiently produce active oxygen, exhibit biological safety, and promote the clinical transformation of sonodynamic therapy.

Cancer Risk and Its Dose-Response Association with Radioactive Iodine Treatment for Hyperthyroidism

Cancer Risk and Its Dose-Response Association with Radioactive Iodine Treatment for Hyperthyroidism

Cancer Risk After Radioactive Iodine Treatment for Hyperthyroidism

Whether radioactive iodine (RAI) therapy for hyperthyroidism can increase cancer risk remains a controversial issue in medicine and public health. To examine site-specific cancer incidence and mortality and to evaluate the radiation dose-response association after RAI treatment for hyperthyroidism. The Medline and Cochrane Library electronic databases, using the Medical Subject Headings terms and text keywords, and Embase, using Emtree, were screened up to October 2020. Study inclusion criteria were as follows: (1) inclusion of patients treated for hyperthyroidism with RAI and followed up until cancer diagnosis or death, (2) inclusion of at least 1 comparison group composed of individuals unexposed to RAI treatment (eg, the general population or patients treated for hyperthyroidism with thyroidectomy or antithyroid drugs) or those exposed to different administered doses of RAI, and (3) inclusion of effect size measures (ie, standardized incidence ratio [SIR], standardized mortality ratio [SMR], hazard ratio [HR], or risk ratio [RR]). Two independent investigators extracted data according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Overall quality assessment followed the recommendations of United Nations Scientific Committee on the Effects of Atomic Radiation. The SIR and SMRs and the RRs and HRs were pooled using random-effects meta-analysis. Cancer incidence and mortality for exposure vs nonexposure to RAI therapy and by level of RAI administered activity. Based on data from 12 studies including 479 452 participants, the overall pooled cancer incidence ratio was 1.02 (95% CI, 0.95-1.09) and the pooled cancer mortality ratio was 0.98 (95% CI, 0.92-1.04) for exposure vs nonexposure to RAI therapy. No statistically significant elevations in risk were observed for specific cancers except thyroid cancer incidence (SIR, 1.86; 95% CI, 1.19-2.92) and mortality (SMR, 2.22; 95% CI, 1.37-3.59). However, inability to control for confounding by indication and other sources of bias were important limitations of studies comparing RAI exposure with nonexposure. In dose-response analysis, RAI was significantly associated with breast and solid cancer mortality (breast cancer mortality, per 370 MBq: 1.35; P = .03; solid cancer mortality, per 370 MBq: 1.14; P = .01), based on 2 studies. In this meta-analysis, the overall pooled cancer risk after exposure to RAI therapy vs nonexposure was not significant, whereas a linear dose-response association between RAI therapy and solid cancer mortality was observed. These findings suggest that radiation-induced cancer risks following RAI therapy for hyperthyroidism are small and, in observational studies, may only be detectable at higher levels of administered dose.

A Dose-Dependent Association of Radioactive Iodine Treatment for Hyperthyroidism with Solid Cancer Mortality

A Dose-Dependent Association of Radioactive Iodine Treatment for Hyperthyroidism with Solid Cancer Mortality

Discussion on radioactive iodine treatment of hyperthyroidism and the risk of induced cancer

Iodine-131 (131I, radioiodine) has been used for over eight decades for the treatment of Graves’ disease, either as initial therapy or following failure of thionamides, as well as for the treatment of autonomous thyroid nodules. 131I treatment is simple to administer, effective, and relatively inexpensive. Recently, there has been some turmoil after a study published in JAMA Internal Medicine reported an increased risk of cancer from 131I treatment. The impact was of short duration however, as the paper received severe criticisms from many nuclear medicine physicians as well as from endocrinologists. Here we explain why that paper's conclusions are doubtful. We also review the major data on the topic of 131I therapy of hyperthyroidism and the risk of cancer.

Cancer Risk After Radioactive Iodine Treatment for Hyperthyroidism: A Cohort Study.

Background: Radioactive iodine (131I) is in widespread use for the treatment of hyperthyroidism. Data on long-term safety outcome are limited and conflicting. The objectives of this study were to evaluate the association of radioiodine treatment for hyperthyroidism with overall cancer and with specific cancer types. Methods: This is a historical cohort study, using the Clalit health care database. Participants were all adults with a new diagnosis of hyperthyroidism in 2002-2015, newly treated with 131I, or with thionamides (propylthiouracil/thiamazole), excluding patients with previous malignancies. Age, sex, smoking history, body mass index, Clalit district, socioeconomic status, history of diabetes mellitus and of hypertension, use of aspirin and of statins, and adherence to cancer screening procedures were used to calculate propensity score to receive radioiodine. Incidence rates and 95% confidence intervals (CIs) were calculated for overall cancer occurrence, and for each cancer type using Poisson distribution. Association between study variables and time to cancer event was evaluated using cause-specific hazard ratios (HR) and CIs, estimated by univariate and propensity score adjusted multivariate Cox proportional hazards models. For sensitivity analysis we stratified the cohort by calendar year at cohort entry and by length of follow-up. Results: A total of 16,637 patients formed the study cohort, with 123,166 person-years of follow-up. There was no association between radioiodine treatment and increased risk of overall cancer (HR = 0.99 [CI 0.83-1.19], p = 0.91; HR = 1.01 [CI 0.83-1.21], p = 0.95) in univariate and multivariate analyses, respectively. However, in a sensitivity analysis, we found an association with overall cancer risk in the first period of follow-up (up to 4.2 years) (HR = 2.11 [CI 1.59-2.80], p < 0.0001), and no association with increased risk in a longer follow-up period. An association was found between radioiodine exposure and an increased risk for non-Hodgkin's lymphoma (NHL) in univariate but a nonsignificant increased risk in multivariate analysis: HR = 2.89 [CI 1.12-7.46], p = 0.03; HR = 2.32 [CI 0.88-6.13], p = 0.09, respectively. Conclusions: No association was found between radioiodine treatment for hyperthyroidism and risk for incident cancer in long-term follow-up. In an analysis of specific cancer types, a statistically significant association was found with NHL only in univariate analysis.

Association of Radioactive Iodine Treatment of Hyperthyroidism With Cancer Mortality: An Unjustified Warning?

Association of Radioactive Iodine Treatment of Hyperthyroidism With Cancer Mortality: An Unjustified Warning?

Evaluation of ultrasonographical and cytological features of thyroid nodules in patients treated with radioactive iodine for hyperthyroidism

Background In this study, we aimed to evaluate ultrasonographical and cytological features of thyroid nodules in patients who were treated with radioactive iodine (RAI) for hyperthyroidism years ago. Methods Patients who had a history of RAI treatment for hyperthyroidism and had thyroid nodules that were evaluated with fine-needle aspiration biopsy (FNAB) were included in the study. Results There were 27 patients (22 female and 5 male) with a mean age of 59.3 ± 13.5. The indication for RAI treatment was Graves in 5 (18.6%), toxic nodular or multinodular goiter in 16 (69.2%), and unknown in 6 (22.2%) patients. A total of 48 thyroid nodules were evaluated with FNAB and cytological diagnosis were benign in 24 (50.0%), nondiagnostic in 15 (31.2%), atypia of undetermined significance in 5 (10.4%), suspicous for malignancy in 2 (4.2%), and malignant in 2 (4.2%) nodules. Thyroidectomy was performed in 10 patients, 5 were benign (50.0%), and 5 (50.0%) were malignant histopathologically. Ultrasonography features of 31 cytologically/histopathologically benign and five cytologically/histopathologically malignant nodules were compared. Prevalence of isoechoic nodules was higher in benign nodules (P = .025). Macrocalcification was observed in 4 (80.0%) of malignant and 10 (32.3%) of benign nodules (P = .042). Conclusion In patients with a history of RAI treatment for hyperthyroidism, thyroid nodules with suspicious ultrasonography features, particulary hypoechoic appearence and macrocalcification, should be evaluated with FNAB irrespective of the time elapsed after RAI treatment.

Fixed dose radioactive iodine treatment for hyperthyroidism: experience of a district general hospital

Fixed dose radioactive iodine treatment for hyperthyroidism: experience of a district general hospital

Radioactive Iodine Treatment for Hyperthyroidism

Radioactive Iodine Treatment for Hyperthyroidism

Increased cancer incidence after radioiodine treatment for hyperthyroidism

Concerns remain about risk of cancer after radioactive iodine (RAI) treatment for hyperthyroidism, especially in organs that concentrate iodine. The objective was to assess the long-term cancer risk from RAI treatment for hyperthyroidism. A total of 2793 hyperthyroid patients treated with RAI at Tampere University Hospital between 1965 and 2002, and 2793 age- and sex-matched reference subjects were followed for an average of 10 years through the Finnish Cancer Registry. Cancer incidence among hyperthyroid patients treated with RAI was higher than in the population-based control group (118.9 vs 94.9 per 10,000 person-years, rate ratio [RR], 1.25; 95% confidence interval [CI]: 1.08-1.46). Furthermore, incidence of stomach (RR, 1.75, 95% CI: 1.00-3.14), kidney (RR, 2.32; 95% CI: 1.06-5.09), and breast (RR, 1.53; 95% CI: 1.07-2.19) cancer was increased among RAI-treated patients. The relative risk of cancer increased with higher RAI dose administered. The increase in cancer incidence was statistically significant in patients treated at the age of 50-59 (RR, 1.44; 95% CI: 1.05-1.97) or older than 70 years (RR, 1.39; 95% CI: 1.05-1.82). There was a 5-year latent period after the RAI treatment before the cancer incidence began to differ between the RAI-treated hyperthyroid patients and the control group. Cancer incidence, especially cancer of the stomach, kidney, and breast, was higher in patients treated with RAI for hyperthyroidism.

Possible Hypothyroidism Associated with Quetiapine

OBJECTIVE:To report a case of hypothyroidism occurring after the addition of quetiapine to an existing drug regimen.CASE SUMMARY:A 46-year-old African-American woman diagnosed with schizoaffective disorder, bipolar type, and a four-year history of successfully treated hyperthyroidism, was suboptimally responsive to olanzapine treatment. Transition from olanzapine to quetiapine was initiated and, approximately two months after adding quetiapine to a standing pharmacotherapeutic regimen, the patient developed an elevated thyroid-stimulating hormone (TSH) concentration of 8.45 μU/L. A diagnosis of hypothyroidism was subsequently made, treatment with levothyroxine was initiated, and the patient's thyroid function became stable.DISCUSSION:Drug-induced hypothyroidism is known to occur with several medications. Quetiapine is an atypical antipsychotic with the potential to decrease thyroid hormone concentrations in some patients; this effect may be dose related. Despite this known adverse effect, the manufacturer of quetiapine reports that elevated TSH concentrations and subsequent treatment with thyroid hormone supplementation have occurred only rarely. We report the development of hypothyroidism in a patient who had previously received successful radioactive iodine treatment for hyperthyroidism in 1994, but who had no detected thyroid abnormalities until treatment with quetiapine was started four years later.CONCLUSIONS:Patients with compromised thyroid function who receive treatment with quetiapine may develop hypothyroidism. Appropriate care for these patients may include an increased awareness of possible hypothyroidism and consideration of thyroid function monitoring.

Acute transitory psychotic reaction manifested after radioactive iodine treatment for hyperthyroidism.

Back to table of contents Previous article Next article ArticleNo AccessACUTE TRANSITORY PSYCHOTIC REACTION MANIFESTED AFTER RADIOACTIVE IODINE TREATMENT FOR HYPERTHYROIDISMKURT WITTONKURT WITTONSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.115.8.746AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "ACUTE TRANSITORY PSYCHOTIC REACTION MANIFESTED AFTER RADIOACTIVE IODINE TREATMENT FOR HYPERTHYROIDISM." American Journal of Psychiatry, 115(8), pp. 746–747 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByExpert Opinion on Drug Safety, Vol. 12, No. 6, Vol. 2 / 2Psychological Medicine, Vol. 1, No. 3British Journal of Psychiatry, Vol. 117, No. 539 Volume 115Issue 8 February 1959Pages 746-747 Metrics PDF download History Published online 1 April 2006 Published in print 1 February 1959